超高分子量聚D,L乳酸小夹板螺钉治疗下颌骨骨折的随机对照研究  

Randomized controlled clinical trial on internal fixation for fracture of mandible with super-high molecular weight PDLLA plates and screws

作　　者：彭勇[1] 耿发云[1] 魏世成[2] 郑谦[2] 李伯友[1] 陈垂史[1] 熊成东[3] 杨德娟[3] 

机构地区：[1]深圳市龙岗中心医院口腔科,广东深圳518116 [2]四川大学华西口腔医学院颌面外科 [3]中国科学院成都有机化学研究所

出　　处：《中国基层医药》2005年第6期641-643,共3页Chinese Journal of Primary Medicine and Pharmacy

基　　金：国家863计划资助项目(编号715002014)

摘　　要：目的评价国产超高分子量聚D,L乳酸(PDLLA)小夹板螺钉在下颌骨骨折内固定中的疗效。方法采用随机抽样的方法,将57例下颌骨单纯性线性骨折分为两组,分别行PDLLA小夹板螺钉内固定和小型钛板内固定。术后观察骨折段复位、咬合关系、咀嚼效能、伤口愈合及局部组织反应等情况。并采用B超观察PDLLA小夹板在患者体内的降解过程。结果PDLLA夹板组内固定术后骨折段的稳定性好,骨折愈合正常,咬合关系恢复良好,无一例出现无菌性炎症,与小型钛板组的疗效相似(P>0.05)。术后2个月咀嚼效能与小型钛板组差异无显著意义(P>0.05)。术后4个月在B超图像上观察到PDLLA夹板开始降解,术后6个月可见夹板断裂,术后1年夹板已基本吸收,仅剩少许残留。结论在下颌骨单纯性线性骨折治疗中,PDLLA小夹板螺钉是一种比小型钛板更理想的骨折内固定系统。Objective To evaluate the clinical effects of internal fixation for fractures of mandible with super-high molecular weight PDLLA plates and screws.Methods 57 fractures of the mandible in 57 patients were treated by open reduction and internal fixation using super-high molecular weight PDLLA plates(31 cases) and titanium plates(26 cases).The duration of intermaxillary fixation ranged from 0 to 14 days.Patients were evaluated clinically by complications and masticatory efficiency,and degradation process of PDLLA was detected with a 7.5MHz ultrasound transducer during the follow-up period,which ranged from 2 to 6 months.Results After giving the internal fixation with PDLLA and titanium plates,all of the fragments have a good stability and normal bone hearing.Four patients(12.9 percent) in the PDLLA group experienced complications of premature occlusal contact.Four patients(15.4 percent) in the titanium group experienced complications of infection(one patient) and premature occlusal contact(three patient).The masticatory efficiency in titanium group was higher than that in PDLLA group at the first month postoperatively(P<0.05),but the masticatory efficiency of the two groups were not significant in the second month postoperatively.Conclusion Bioabsorbable PDLLA plates can be selectively used for internal fixation in single linear mandibular fractures,with the advantage that they do not need to be removed.

关 键 词：超高分子量聚D L乳酸 小夹板螺钉 治疗 下颌骨骨折 对照研究 

分 类 号：R782.2[医药卫生—口腔医学]